骨骺未闭的青少年内侧髌骨韧带重建术中股骨隧道定位点的研究  

Study on the positioning of the femoral tunnel for medial patellofemoral ligament reconstruction on the adolescent

作　　者：刘阳[1] 尼加提.阿不力米提 孙学斌[1] 李纲[1] 张克远[1] LIU Yang Nijati Abulimiti SUN Xuebin LI Gang ZHANG Keyuan(Department of bone tumour, The First Affiliated Hospital of Xinjiang Medical university, Urumqi 830054, Chin)

机构地区：[1]新疆医科大学第一附属医院骨肿瘤科,乌鲁木齐830054

出　　处：《新疆医科大学学报》2017年第6期747-750,共4页Journal of Xinjiang Medical University

基　　金：新疆医科大学第一附属医院科研基金(2014ZRQN14);新疆维吾尔自治区自然科学基金(2016D01C286)

摘　　要：目的探讨骨骺未闭的青少年膝内侧髌股韧带重建术中股骨隧道定位变化对移植物等距特性的影响。方法选择2015年6月-2016年10月新疆医科大学第一附属医院骨肿瘤科收治的16岁以下骨骺未闭的青少年患者共10例20膝,分别行0°、30°、60°三维CT重建,以Schttle确定的股骨侧定位点为基点G,分别取G点上方5mm为点A,A点前方5mm为点B,A点上方5mm为点C,G点下方5mm为点D,D点前方5mm为点E,G点下方1cm为点F点,取髌骨内侧缘近端1/3为O点。分别测量不同角度下相对应各点的长度,记为OA、OB、OC、OD、OE、OF、OG。结果膝关节屈曲0°、30°、60°时,变化长度最短的为OG(2.4±1.4)mm,变化长度最长的为OC(7.6±2.7)mm;两两比较中,OA的变化长度[(3.2±1.2)mm]和OB变化长度[(3.6±1.3)mm]差异无统计学意义(P>0.05),其余各股骨定位点比较差异均有统计学意义(P<0.05)。相同股骨定位点在不同角度所得长度变化平均值差异均有统计学意义(P<0.05)。股骨定位点在0°位时OF的长度最长[(56.3±2.4)mm],OC的长度最短[(45.5±2.4)mm];股骨定位点在60°时OC的长度最长[(56.3±2.1)mm],OE点最短[(45.2±2.1)mm]。结论对于骨骺未闭的青少年膝关节MPFL重建术中,股骨侧定位点选择在G、A、B 3点之间的区域可提供正常的膝关节生物力学功能。Objective To explore the influence of functional length changes of various femoral fixation sites adolescent. Methods There were total of 10 cases including 20 knees of adolescent patient hospitalized from June 2015 to October 2016 in our department. Twenty knees of adolescent examined at early flexion angles （0°, 30° and 60°） with horizontal-type open computerized tomography scans. Seven points on the femoral condyle were simulated. The MPFL length changes were analyzed at various flexion degrees. Re- sults Knee flexion 0 degree, 30 degrees, 60 degrees, change the length of the shortest OG （2.4 ± 1.4）mm, change the length of the longest for OC（7.6±2.7）mm; 22, changes in the length of OA [（3.2±1.2）mm] and OB [（3.6±1.3）mm] length change there was no significant difference of mm （P 〉0.05）, the rest of the femur positioning point were statistically significant （P 〈0.05）. There was a significant difference in the average length of the same femur location points at different angles （P 〈0.05）. The length of OF was [（56.3±2.4）mm], and the length of OC was the shortest [（45.5±2.4）mm] in the location of the femur. The length of OC is [（56.3±2.1） mm], and OE is the shortest [（45.2±2.1）mm]. Conclusion The femo- ral fixation site may be more accurately located during MPFL reconstruction at the G, A, and B points to restore the native biomechanical function of the MPFL.

关 键 词：内侧髌骨韧带 股骨隧道 青少年 等长性 

分 类 号：R686.5[医药卫生—骨科学]